ON the Orthopaedic Surgical Service of the US Navy hospital ship USS Repose in the Vietnam theater, basic tenets of combat surgical technique are practiced. These are (1) wide exposure of the wound, (2) thorough excision of devitalized tissue, (3) removal of large unattached bone fragments and foreign bodies, and (4) open drainage and immobilization.
At this point, diversion of thought regarding methods of wound care may occur. One technique, that of open dressing of wounds with treatment by topical antibiotic or chemical solutions such as neomycin or silver nitrate is an acceptable and often successful form of therapy. A second technique is that of closed wound coverage without dressing change. Both techniques have been used widely in the latter half of World War II and the Korean Conflict. In the intervening years between military conflict, the closed technique has fallen into less frequent use.Many wounds are of